Page 16 - World Journal of Laparoscopic Surgery

Ganeshselvi Premkumar

Contd...

Author Sample Classification Selection criteria Intervention Follow-up Outcome
size PR LBR MR ER
Jones and Sutton 39 rAFS Moderate/severe endo Lap KTP laser, 12 months 39.5%
2002 endometrioma Diathermy
(2-25 cm)
Porpora et al 47 rAFS Adnexal adhesion Lap excise, Ablate 12-60 months 64.4%
2002 Tubal status adhesiolysis
Elsheikh et al 151 rAFS Endometriosis Laparoscopy, 2 year 53%
2003 No or medical treat
Vercellini et al rAFS Endometrioma Lap cautery or laser Variable 24-60%
2003 Lap cystectomy
Alborzi et al 100 rAFS Endometrioma Lap excision 12 months 59.4%
2004 > 3 cm Lap fenestration 23.3%
and coagulation
of wall
Godinjak et al 45 rAFS Endometrioma Lap cystectomy 1 year 35%
2005
PR—Pregnancy rate, LBR—Live birth rate, MR—Miscarriage rate, ER—Ectopic pregnancy rate (number): Number of cases in relation to sample
size, rAFS—Revised American Fertility Society

CONCLUSION 3. Keettel WC, Stein RJ. The viability of the cast-off menstrual
endometrium. Am J Obstet Gynecol 1951; 61(2):440- 442.
There is no large, prospective, randomized double-blind 4. Meyer R. Uber den stand der frage der adenomyositis und
controlled trial that specifically addresses the question “does adenomyome im allgemeinen und ins besondere uber
laparoscopic surgery in moderate-severe endometriosis improve adenomyositis seroepithelialis und adenomyometritis
pregnancy rates?” A better classification is needed which would sarcomatosa. Zentralb Gynak 1919;36:745-50.
correlate symptoms and fertility and aid selection of appropriate 5. Wolfer MM, Nagele F, Kolbus A. A predictive model for
treatment. There is good enough evidence to suggest that endometriosis. Hum Reprod 2005;20:1702-08.
endometriomata greater than three centimeters in diameter 6. Matsuzaki S, Canis M, Pouly JL. Cycloxygenase-2 expression
should be excised and examined histologically. In spite of in deep endometriosis and matched eutopic endometrium. Fertil
heterogeneity among the available studies, current evidence Steril 2004;82:1309-15.
suggests that laparoscopic excision or ablation either by 7. Akande VA, Hunt LP, Cahill DJ, Jenkins JM. Differences in
time to natural conception between women with unexplained
electrocautery or laser improves pregnancy rates both by natural infertility and infertile women with minor endometriosis. Hum
and assisted conception. Assisted Reproductive Techniques Reprod 2004;19,96-103.
should be considered if conception has not occurred by 12 8. Huffmann JW. External endometriosis. Am J Obstet Gynecol
months after surgery. 1951;62:1243-52.
9. Acosta AA, Buttram VC, Besch PK, Malinak LR, et al. A
ACKNOWLEDGMENTS proposed classification of endometriosis. Obstet Gynecol
1973;42:19-25.
My sincere thanks to Dr Caroline Overton and Dr Valentine 10. Schenken RS, Guzick DS. Revised American Fertility Society
Akande for their support. Classification- 1996. Fertility and Sterility 1997;67(5):815-16.
11. Roberts CP, Rock JA. The current staging system for
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